10 things you must know before having cosmetic eyelid surgery.

1. How does the mid face age?

The triangular area formed between the two corners of the eye and the corner of the mouth makes up the mid face. The mid face is an essential component of an attractive face. With the aging process, two processes occur: 1) sagging of the fatty tissue that normally drapes over the cheekbones, and 2) loss of tissue volume from fat and muscles. This results in less prominent cheekbones and a droopy fold of skin and fat between the nose and the cheek (the nasolabial fold). The tear trough (the area between the lower lid and the cheek) becomes more prominent with aging, causing more apparent and prominent lower eyelid bags.

2. What can a cheek lift achieve?

Using minimally invasive cheek and mid face lift techniques with limited incisions, the droopy cheek tissue can be lifted up over the cheekbone, thereby restoring the more prominent youthful contour, improving the tear trough and bagginess of the lower lids, and softening the undesirable cheek fold.

3. What are different techniques used for a mid face or cheek lift?

  •  ENDOSCOPIC MID FACE LIFT

    As with the endoscopic brow-lift , an endoscope is used after making small incisions at the temple and inside the mouth. Dr. Parsa uses the sub-periosteal approach to the mid face tissue, a deep technique where all the tissues are lifted from the cheekbones and re-suspended in a higher place. Suspension can be achieved by sutures or Endotine, which is an absorbable implant that aids in maintaining the position of the tissues after a cheek or mid face lift.

  •  SOOF LIFT

    The SOOF (sub-orbicularis oculi fat) is an acronym for the fatty tissue of the uppermost part of the cheek. The incision to reach the SOOF can be made through a transconjunctival lower lid approach, or a transcutaneous lower lid approach. This mid-face lift technique typically has less swelling associated with it.

4. What is cheek augmentation?

Cheek augmentation can help restore the well-formed cheekbones you used to have when you were young, or if you have never had well-defined cheekbones, may give your face the desired contour of higher cheekbones. Cheek implants are made in various shapes and sizes, depending on the area to be augmented. They are made out of permanent solid materials that have been used successfully for years. These implants are typically inserted through hidden incisions inside the mouth, between the upper lip and the gums. A pocket is created over the bone and the proper size and shaped implant is placed. After healing, the implant generally feels as if it is part of your own cheekbone.

5. What material is used for cheek augmentation?

Dr. Parsa uses Gore-Tex, Medpore or Silastic (medical-grade Silicone rubber) implants. These implants are stable and they do not reabsorb, so the result is permanent.

6. What type of anesthesia is used for cheek lift or augmentation surgery?

Both cheeklift and cheek augmentation can be performed under Monitored Anesthesia Care (MAC). This type of anesthesia is performed by an anesthesiologist. The main advantages of this anesthesia are: (1) it does not require putting a breathing tube in the throat, (2) it does not require a breathing machine, (3) the recovery is much faster, (4) there is less nausea after surgery. All of these elements translate into greater comfort and safety. During MAC anesthesia an intravenous needle is placed into one of the veins of the arm or hand. Relaxing medication is given to make the patient fall asleep. The amount of medication is adjusted as needed. After the patient is asleep, numbing medicine is also placed in the skin of the area that is being operated on. During the procedure the patient is unaware of anything going on and cannot hear anything, yet he or she is breathing normally.

7. What is recovery like?

For a midface or cheek lift, most patients experience minimal discomfort after the procedure. Most swelling will generally improve over one week, however it will take several weeks for all the swelling to resolve. Most individuals will return to work and social activities within 7 to 10 days, although some swelling will still be present. With the cheek augmentation procedure the cheeks may feel tight, and chewing may be uncomfortable in the first few days. Movement of the mouth and hard chewing should be limited. Pain medication can lessen discomfort. Stitches in the mouth dissolve in approximately 7 to 10 days. Most swelling subsides within 2 weeks, although the results of the surgery may not be fully visible for as long as 3 to 4 months.

8. I am interested! How should I proceed?

If you are considering this procedure we encourage you to schedule a private consultation with Dr. Parsa. During this visit he will listen to your concerns and, after a comprehensive evaluation, will discuss the best management for you. If you are a suitable candidate depending on your gender, ethnicity, and age, a customized procedure will be tailored for you. If you are an out of town patient visiting our Beverly Hills Office, please do not hesitate to contact us to help arrange your travel plans.

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